The following is a conversation between Dr. Barbara Van Dahlen, founder and President of Give an Hour, and Denver Frederick, Host of The Business of Giving on AM 970 The Answer WNYM in New York City.

Denver: Approximately one in five adults in the US, nearly 20%, experiences mental illness in a given year; and each day, an estimated 18 to 22 veterans die by suicide. An organization that is not only bringing unprecedented attention to this issue, but real action and solutions to address it is Give an Hour, who has had a remarkable impact since its founding less than 15 years ago. And it’s a pleasure to have with us this evening, the founder and president of Give an Hour, Dr. Barbara Van Dahlen. Good evening, Barbara, and welcome to The Business of Giving.

Dr. Barbara Van Dahlen

Barbara: Hello, Denver, and thank you for having me.

Denver: Share with us the mission and objectives of Give an Hour.

Barbara: Sure. Give an Hour, when I first founded the organization nearly 15 years ago, the idea was to harness skill-based volunteers to address the acute and chronic issues that affect our society. We began by harnessing mental health professionals because I am one, and we focused first on our veteran service members and their families. So, that was the beginning. It’s really to harness skill-based volunteers and direct those skills to situations, populations in need.

… we know that more people die each year in the United States by suicide than die in car accidents. We know that approximately 800,000 people die by suicide around the world each year.

…Social media, while it can be an incredibly powerful force for good, it may also be contributing to people feeling more isolated…That wonderful fear of missing out, FOMO.

Denver: We mentioned that about one in five people will have some mental illness episode during the course of a year. Do we know whether that number is on the rise with pressures of modern society? Or are we just simply more aware of it?

Barbara: We’re definitely more aware of it, which is good, and we also know – just to give your listeners another number or two – we know that more people die each year in the United States by suicide than die in car accidents. We know that approximately 800,000 people die by suicide around the world each year. I mentioned suicide because we do know that the suicide rates are on the rise, and some groups even more so– young girl– which is horrifying and frightening. And this is very concerning.

Suicide is a very complex, complicated issue. But we do think that there are multiple factors contributing: the stress as you mentioned, the lack of community that we used to have that really protected us. Social media, while it can be an incredibly powerful force for good, it may also be contributing to people feeling more isolated… That wonderful fear of missing out, FOMO. When my daughter first started to say that, I was like, “What is that?” It’s a real thing, and it can cause people who are already feeling bad, to feel worse.

40% to 50% of people who are dealing with any kind of mental health challenge will ever get any kind of help. Part of that is that many people who have a diagnosable mental health condition, as you mentioned: one in five here in the US, one in four around the world, they may not even know that they’re walking around with something that’s affecting their family, their work, their sense of self, their ability to enjoy life.

Denver: You can go into some pretty dark places on the internet. There’s no question about that. Do many people receive any kind of help?

Barbara: We are working on it, and we’ll talk about that, I know, a little bit later about the work we’re doing to change that. But historically, no. The numbers are, even under the best circumstances, 40% to 50% of people who are dealing with any kind of mental health challenge will ever get any kind of help. Part of that is that many people who have a diagnosable mental health condition, as you mentioned: one in five here in the US, one in four around the world, they may not even know that they’re walking around with something that’s affecting their family, their work, their sense of self, their ability to enjoy life.

Denver: Let me ask you one more question about this. Do we have an estimate of the societal cost of mental illness? And do we have any projections over the next decade or two?

Barbara: We know that globally, mental illness and unaddressed mental health will surpass the cost of cancer, diabetes, and respiratory infections combined. We’re talking trillions of dollars already, and trillions more expected in the next decade. I think what we’re seeing now is an appreciation that unaddressed mental health issues here in our country and around the world is the number one health crisis that we’re facing.

Denver: I think you’re right. You were in Washington, DC on 9/11, and it could be fair to say that the genesis of Give an Hour started then. Tell us about that day and the journey that it launched.

Barbara: I think it’s absolutely fair to say. I dropped my five-year-old daughter off at her school. It was a beautiful blue-sky day in DC just like it was in New York. I drove, and my one-year-old was at home with our nanny. I stopped at Safeway. I will never forget this. I stopped at Safeway. I picked up a couple of things, and in the check-out line, I was standing with one other man. The checker turned to us both and said, “I just heard the strangest thing on the radio. A plane hit one of the World Trade Center Towers.” All three of us looked at each other with this sick feeling. I got in my car. I turned on the radio. Drove the next 5 to 10 minutes almost as fast as I could to get home, and I literally stood holding my one-year-old daughter watching the Twin Towers fall on the Today Show. It was for all of us horrific. For me, because I’m a psychologist, my immediate reaction was, I want to help. I need to help. I had a really hard time finding a way to help, finding a way to give.

Denver: So, what you did is you reached out to your fellow mental health professionals. It’s hard for me to even conceive of the Dark Ages it was back then. The internet did not exist the way it does today. There was no Facebook, but there was Craigslist.

Barbara: There was Craigslist. Thank the Lord for Craigslist. I’ve had a chance to… many years ago, I met Craig, and we’ve seen each other over the years.

Denver: He was a guest just a few weeks ago.

Barbara: He’s a dear man, and he cares deeply about giving back and doing good. I am not a technologically savvy human being. But I knew about Craigslist because I had used it at that time. As I was building Give an Hour, I was going through a rather painful divorce because of some of the factors that affected my own emotional health and well-being growing up – another part of the story. I had found a wonderful nanny who was trading time, so that she could find a home to go to school, finish her work… her undergraduate education, and she was trading childcare. Wow! This Craigslist thing! if it can do that, why can’t I use it to bring mental health professionals together to provide free care to those who serve and their families? That’s what we began to do.

Denver: What is the significance of Give an Hour?

Barbara: For most folks who have never been to see a counselor or a therapist, they may not understand this; but those of your listeners who have will understand that most therapists – again, in the old days, this is changing, and this is a good thing. In the old days, mental health professionals typically saw someone by the hour. So, my thought was if I’m here, and I’m willing to give an hour of my time, set aside an hour in my practice… because I had two practices at that time – then I assume that other people like me would be willing to give an hour. I was literally driving around in my mom van with my daughters, who were a little older now… as we’re moving past 9/11… three to four years later. I’m sort of talking about this idea out loud. But I can’t figure out what to call it. I’m going to ask psychologists and psychiatrists to give an hour of their time to help these veterans and service members. My nine-year-old daughter said, “Mommy, just call it “Give an Hour.” I was like, “Okay, there you go.” And so we did.

Denver: That’s a wonderful name, I think, because so often people describe the condition or the malady or whatever. This is describing the action that you’re asking people to take. It really just creates energy in so many different ways. How many people have you been able to get to volunteer to give that hour? And how many hours have they given?

Barbara: At any point in time over the last 13, 14 years, we’ve had between 5,000 and 7,000 mental health professionals in our network. Collectively, they have given over 277,000 hours of free care. That’s only what we can count. I’m a stickler for this. Sometimes people say, “You should extrapolate.” Because we survey our providers, and we get about a 15% return on surveys every quarter. We actually can count those 277,000 hours, but that’s about 15% of our total pool. We could multiply that, say we assume that it’s many, many times that. But I’m happy with 277,000 hours, or about $28 million worth of free care.

My dad served in the Pacific, clearly came home with post-traumatic stress. We didn’t know what it was. He didn’t know what it was. But it affected him. In addition to dealing with that, he was dealing with having a very mentally ill wife and three little boys and a baby girl in rural California. He was just an amazing man. I knew that if we could get help to these service members when they were coming back, rather than 10, 15, 20 years later, we could prevent what happened after Vietnam.

Denver: Well, I’m impressed. And your initial focus, as we mentioned before, was the military.

Barbara: Yes. My father served in World War II. I was very close to my dad. He raised us after my mom had a psychotic break soon after I was born, which absolutely set the course of my life. My dad served in the Pacific, clearly came home with post-traumatic stress. We didn’t know what it was. He didn’t know what it was. But it affected him. In addition to dealing with that, he was dealing with having a very mentally ill wife and three little boys and a baby girl in rural California. He was just an amazing man. I knew that if we could get help to these service members when they were coming back, rather than 10, 15, 20 years later, we could prevent what happened after Vietnam.

Denver: Of these 277,000 hours, how do these service men and women find you? And what occurs during that hour?

Barbara: That’s a good question because sometimes people think that mental health professionals who are in our network, they only give one hour. But they actually commit to give an hour a week ongoing. They may see someone five hours. They may see someone 30 hours. It’s whatever the person needs. People find us by going to our website, giveanhour.org. That’s one way. We partner with everyone under the sun – the VA, the Department of Defense; 125 military and veteran organizations. We have alot, alot, alot of warm handoffs coming to us. When they find out about us, when they receive that suggestion or that opportunity, they work with a counselor or therapist just like anyone else would. You either go in to the office and see someone face to face like we’re sitting here today. They may do a phone support, phone counseling. Now, thanks to technology, we provide telehealth, which is a secure link that allows a therapist and his/her client to see each other using video like Facetime or like Skype to provide counseling that way.

Denver: A number of years ago, you decided to broaden your universe. What prompted you to extend your reach to other populations beyond military and veterans?

Barbara: We had this network growing. People were already starting to ask us, “Could we apply this model elsewhere?” But we were then and still are, a small, lean, mean nonprofit. I live in Washington, DC, and it was this time of year many years ago now, the Virginia Tech shooting occurred which was horribly upsetting and tragic. I thought: we have this network right here. That was the first time we opened the network up to offer free care to others affected by some kind of acute trauma. Since then, we have opened the network up countless times. Every time there’s a national disaster or man-made trauma. All the floods, the fires, the mass shootings. All of them far too frequent. Then, a few years ago, we actually did begin to expand the model and provide care to other populations, specifically those affected by gun violence, at-risk teens. Now we’re partnering with others to bring this expertise and this care to those who are hurting around the country, and now we’re expanding internationally.

Dr. Barbara Van Dahlen and Denver Frederick inside the studio

Denver: The centerpiece of this expanded universe is the Campaign to Change Direction. What is the major objective of that campaign?

Barbara: There was actually then another trauma. You mentioned these things happening far too often. At the end of 2012, our nation experienced, in my lifetime, one of those almost unbearable national traumas, and that was the shootings at the Sandy Hook Elementary School. After that, Vice President Biden’s office reached out to me because we were working closely with the Obama administration during that time on veterans and military care; the Vice President’s office was really starting to look at mental health. The question to us was, “Look, you’ve built this organization focused on military and veteran mental health and well-being, what are we missing as a nation?” So, I put together a small group of people, like I do when I’m trying to create an answer to a question. Within a very short amount of time, we came up with this really basic truth which is: If we are ever going to get in front of mental health challenges, issues, suicide, pain and suffering, we’ve got to change our culture because it is our culture that prevents people from recognizing their emotional pain and suffering, and most important, from taking that step to get help.

It’s an amazing process. It’s very organic. You can seed it. You can encourage it. You can facilitate it. But you can’t predict it. You can’t really plan the way you might plan an event. You can do a lot of things, and we are doing a lot of things. What we’re seeing is that we came upon this at the right time. People want to talk about these things. We’re seeing a tipping point. I can see it. I can feel it. People are more open. You and I were talking about examples of culture change that we’ve lived through – one being legalization of gay marriage and the acceptance of that, which has happened in a blink of an eye.

Denver: What have you learned since that day to now about changing culture?

Barbara: It’s an amazing process. It’s very organic. You can seed it. You can encourage it. You can facilitate it. But you can’t predict it. You can’t really plan the way you might plan an event. You can do a lot of things, and we are doing a lot of things. What we’re seeing is that we came upon this at the right time. People want to talk about these things. We’re seeing a tipping point. I can see it. I can feel it. People are more open. You and I were talking about examples of culture change that we’ve lived through – one being legalization of gay marriage and the acceptance of that, which has happened in a blink of an eye. So fast compared to some other cultural changes, and I think changing the culture around mental health, and what we mean by that is: mental health is part of all of us every single day. You and I today are experiencing our mental health just like we experience our physical health. Today, both are pretty good for me. I don’t know how you’re doing, but I’m pretty good.

I feel good. There’s nothing stressing on me from the outside. I’m not dealing with anything bubbling up from the inside. Physically, I’m feeling pretty good too, thank you very much. But we, as a people, we don’t deal with our mental health that way. We talk about mental health as if that means a disorder. That’s not the case. So, what we’re working to do every single day with hundreds of hundreds of partners is sharing stories, is encouraging people to be open, is to increasing access to care. Removing barriers. This is a public health approach. It’s for everyone because we all have experienced emotional pain, and many, many of us have experienced mental health challenges.

Denver: Picking up what you said a moment ago about how it is organic, it made me think about the Ice Bucket Challenge that nobody could have predicted. It wasn’t that great an idea. Maybe it was, but $115 million later, and you just can’t replicate those things. You don’t even know when they’re going to happen or where they’re going to come from.

A big part of your program is identifying the five signs of emotional pain. Speak about that and share those five signs with us.

Barbara: Absolutely. That came about because my brain seems to take really complex things and makes them very simple: give an hour. In this case, when we thought about changing the culture, what we knew was missing was public health. We had never seen a public health campaign focused on mental health. You often hear of anti-stigma efforts. This is not that. We thought about what great public health campaigns are out there that we could look to for guidance. I don’t know when I learned the signs of a heart attack. But somewhere, I picked them up enough to know that if I saw you, Denver, right now starting to sweat profusely, complaining you felt pressure in your chest, your left arm was hurting, I would immediately think, “Oh my God. He might be having a heart attack!” Now, we know some signs of stroke. These things help us quickly recognize we need to take action. You don’t need to be a cardiologist or a neurologist to take action. We reasoned that if we created a basic language that everyone could share, we would be moving us toward this public health approach.

The five signs of suffering are: First is personality change. Someone is not the way they used to be. All these are things that we can all observe, and people tell us afterwards, “He changed, He changed.” The second is agitation. It could be anger; it could be anxiety; it could be: “I’m not sleeping – I’m pacing. I can’t calm down. I feel like I’m jumping out of my skin.” The third is withdrawal. We’re not expecting everybody to be comfortable sitting with Denver having a conversation on the radio. Many people are introverts; that’s fine. But we all have our social network comfort zone. The fourth is taking care of ourselves. If you see someone who used to be out and about – they go to the gym, they take care of themselves; and all of a sudden, they’re not doing any of those things, or they’re drinking too much, or they’re driving too fast. These are signs they’re not taking care of themselves. The last one is hopelessness. When someone feels hopeless, they communicate it by their actions, often by their very words.

We want people to recognize those signs in themselves or someone they love, and when they see them, it’s time to act. All you’ve got to do is reach out and say, “I see that you’re hurting. I don’t know why, but I want to help.”

“Are you sleeping right?” Anybody who’s been sleep-deprived knows it affects you emotionally. “Are you eating well?” Nutrition. “Are you getting enough exercise? Are you checking in with others?” We should all keep our loved ones up-to-date about how we’re doing, and they should keep us up-to-date on how we’re doing. “Are our relationships healthy?” One of the things I love to say to teenagers is, “If your relationships are a train wreck, you cannot be healthy.”

Denver: Let me pick up on one of those, and that would be self-care. What are some of the healthy habits of emotional well-being that we should all practice.

Barbara: Yes. You picked up on we launched The Healthy Habits, a good public health campaign. You’ve got to talk about, what do you do? These healthy habits are meant to help, really encourage people to understand that many different things affect our emotional well-being. “Are you sleeping right?” Anybody who’s been sleep-deprived knows it affects you emotionally. “Are you eating well?” Nutrition. “Are you getting enough exercise? Are you checking in with others?” We should all keep our loved ones up to date about how we’re doing, and they should keep us up to date on how we’re doing.” Are our relationships healthy?” One of the things I love to say to teenagers is, “If your relationships are a train wreck, you cannot be healthy.” I don’t care what you say to yourself. So, look at your relationships.

Also, life is stressful. It can be good stressful. It can be difficult stressful. But it’s stressful. So, figure out what you do, what works for you. I swim, I used to run. Some people garden. They sing. They dance. All of those things are good for our emotional well-being. Lastly, make sure you know those five signs.

Denver: You’ve been able to draw a lot of attention to this campaign through celebrities. Speak a little bit about who they’ve been and what they’ve done for you.

Barbara: Our first champion for the Campaign to Change Direction was Michelle Obama. She worked with us. It was a huge, wonderful start, and she came on board because we were working in the military and veterans base wanting to talk about well-being; not wanting people to think that veterans were broken because they’re not. If they’re dealing with emotional pain and suffering, many of us are too. So, she came on board, and we were honored. She did several different things for us – PSAs and appearances.

Dr. Jill Biden and Vice President Biden have both been with us. Vice President Biden was just with us in London at our second global summit. We’ve also worked with Richard Gere. We’ve worked with Chris Stapleton for you country music fans. Amazing. Ben Foster, Paul Dano, Bill Pohlad, Oren Moverman, Prince Harry….

Denver: …did your first PSA.

Barbara: Yes he did… again on reaching those who serve and our veterans. We have been blessed and fortunate, and I think that as we were talking earlier, the time has come for this. People are stepping up to help. It still is not a sexy topic. My husband, who’s also a psychologist, used to say, “We don’t have a poster child,” because people still are awkward or uncomfortable. So we’re not one of those issues or causes that people are quick to help because they want our help, but they almost don’t want to say that they want our help.

Denver: You don’t have a picture of somebody who is suffering from mental illness the way you do for a lot of other things.

Barbara: Exactly, and we don’t ever, ever, ever… and we’ve been asked to, we have refused. We do not exploit anyone who is dealing with emotional pain.

Denver: Well, one thing you’re going to exploit is going to be a week in June. That is going to be A Week to Change Direction. When is that going to be? And what’s going to happen?

Barbara: June 9th through 15th. It’s coming up. This is a week that we want everyone and anyone who cares about emotional health and well-being to join us for the first ever globally coordinated week to focus on mental health culture change. We have people all over the world. You can be an individual. You can represent an organization, and you can do whatever you want. Just join us that week. Come up with an activity. It can be in-person. It can be online. It can be a book club. We have a toolkit that we will happily send out. You can go to changedirection.org. We’ll send it to you. All we ask is that during that week, use #changedirectiontogether, and then whatever your hashtag is. We want to amplify, elevate all the amazing work that is happening. Get everyone’s attention. Help people come out of the darkness. Share their pain. Share their resilience; share their stories, and change the culture of mental health.

Denver: You have a wonderful partner who’s going to help you do this, IBM. What’s going to happen with that?

Barbara: IBM, they have stepped up to give us access to the IBM Innovation Jam platform. Again, not being a technologically savvy individual, I was like, “What the heck was that?” I want it. Whatever it is, I’ll take it. It’s sort of like Facebook on steroids. They can host thousands of thousands of people simultaneously for a two-and-a-half day, 24 hours-a-day conversation that we will host, facilitate. We’ll have VIPs; we’ll have special guests; we’ll have celebrities dropping in to talk about and share perspective. Anyone out there, come visit changedirection.org. You’ll find out how to join the Jam, and we want to make as much noise as humanly possible.

Denver: Let me ask you one more question about stress, and that’s stress in the workplace. We can all feel it. Many more people feel it than I think we even realize when you look at some of the surveys. What should employers do in helping their people address that stress? And maybe some partners that you’ve had who’ve done some creative things in that realm?

Barbara: The good news is: there seems to be a change coming when it comes to employers. They are recognizing they have to do more than put a gym in their building. That’s great. That’s one of those healthy habits. But it’s not enough. Employers, some of them, because they’re moved by the pain and suffering that they’re recognizing; others because they’re very smart, and they see that the bottom line is being affected by unaddressed mental health issues in the workplace. Again, one in five of us, that means that those are people in the workforce who are not able to perform because they’re struggling.

Companies are now recognizing and moving past the traditional EAP – that was a long walk of shame. “I’m being referred to the EAP, I must have done something wrong,” as opposed to bringing emotional health and well-being into the workplace. So, we’re seeing programs, we’re seeing lots of conversations with us, and any employer out there who wants to talk, we have very basic emotional life skills modules, training that we are working with several now companies who have grabbed onto this – Booz Allen, I’ll give them a shoutout. They were one of the first to join us and said, “We have got to bring this to our managers who can bring this to their direct reports, and support each other.”

What we are seeing with all of our friends in the HR sector, they are eager. They will be definitely part of that jam. We have a lot of companies. British Telecom is another; stepping in to say, How can we bring this cultural change inside the workplace, make it okay for people to share with each other appropriately, support each other? Because, guess what! When you do that, you’re more productive. You don’t end up needing to hide or feel embarrassed or ashamed. You are part of the productive community that you want to be. People want to thrive. Employers are getting smart about it. We are delighted and happy to receive partners who want to do more good work together.

Denver: Speaking of workplace culture, what about your corporate culture? What makes Give an Hour such a special place in which to work?

Barbara: I think we walk the walk, in addition to sharing and talking about this. We’re a virtual organization. We don’t have an office building. Everybody works in their PJs if they’re not out at a meeting. We are very focused on bringing military and veteran… either folks who have served, or family members… into our organization. Many people who are with us are, I was starting to say, have lived experience but again, one in five of us do anyway. But they’re very open about it. They’re happy to talk about it. We support each other. We’re very family-friendly. We’re very committed. I think that people who work at Give an Hour believe that this is the way forward to build a healthier, more productive, safer community and world, and that’s what they want to do.

Denver: Let me close with this, Barbara. You recently launched a podcast called Inner Space. Tell us about it, maybe who some of your guests have been, and where people can go find it.

Barbara: Thank you, Denver. Inner Space, I love this opportunity. As a psychologist, I spent much of my early career interviewing people as part of the process of doing therapy. So, I come to this ability, a very naturally by background; I love to talk to people. I love to learn about people. Inner Space is all about helping us change the culture on mental health, helping us learn what works for people, helping us burst through some of these barriers.

We’ve had some amazing guests already on the show. Talinda Bennington, who lost her husband, Chester, who is the lead singer of Linkin Park. She’s a dear friend of mine. DJ Nash, the creator of A Million Little Things, an ABC drama that I have the good fortune… I’m the consultant for that show. I love that show. I’ll give them a good plug. We’ve also had Ana Shinoda, who is an author. We had Vice President Biden. We featured his remarks from our summit. We’ve also had Minister Tobias Ellwood, the Minister of Defense from the UK. Sean Brosnan, the son of Pierce Brosnan told his story. Darrell Hammond, the comedian shared his struggle with substance use that resulted from a really abusive early childhood.

Everyone who comes on, their focus is on, “Hear is my story, here’s what I’ve learned. Here is what works for me. Here is what I’m doing next.” It’s very uplifting, inspiring. I always feel great after the interviews. We’re very proud of the work that we’re doing and thrilled to have folks tune in to Inner Space anywhere where you can find your podcast.

Denver: Sounds worth a listen. Dr. Barbara Van Dahlen, founder and president of Give an Hour, I want to thank you so much for being here this evening. There is certainly no shortage of options for people to become involved. Tell us a little bit more about your website and some of the things that they can do.

Barbara: Our website is giveanhour.org and changedirection.org. They each connect to the other. So, you can go to one and find the other. If you’re a mental health professional, please give us an hour a week. You get to choose the kind of work you do, how you do it. There are 500,000 mental health professionals in our country. We have about 7,000. I want them all because imagine what we could do. If you’re a mental health professional, join us. If you are a partner that wants to expand the mental health care and support that you’re doing in your organization, your company, your university, come talk to us, and let us work together with you. Obviously, if you’re a funder, we definitely need your support. We can’t do this work without it. If you’re a celebrity, and you want to lend your voice and your creativity, we’re all for that. Come on in.

Denver: She’s booking guests now. Thanks, Barbara. It was a real pleasure to have you on the show.

Barbara: Thank you, Denver, and thank you for the good work you do.

Denver: I’ll be back with more of The Business of Giving right after this.